Removal of a fully metallized right coronary artery with stents and multiple false aneurysms after previous recanalization of chronic occlusion and sequential stenting along the entire length

Despite the latest advances in pharmacological, endovascular and surgical treatment of patients with coronary artery atherosclerosis, coronary artery disease is still the leading cause of disability and mortality. Since 2019, more than 10% of coronary artery bypass grafting surgeries have been performed after previous coronary artery stenting. With expansion of indications and high classes of recommendations for percutaneous coronary interventions, patients with total stenting of ≥1 coronary artery are common. This creates a very serious problem for coronary artery bypass surgery. The phenomenon of total metallization of coronary artery, known as a full metal jacket, has arisen. We have encountered a rare case of previous recanalization of chronic prolonged occlusion and subsequent stenting of the right coronary artery along the entire length complicated by multiple perforations and false aneurysms. We present a patient with such a complication who required surgical treatment and manipulations with totally metallized right coronary artery.